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Wed Oct 4 21:19:07 BST 2006

OK, it's possible I overstated the case for the sake of a little argument
(the list has been rather quiet recently!) but there are trends here which I
believe are important.  First, clearly if you are a member of this list,
attend trauma conferences, or are an attending at a level 1 trauma centre,
chances are that you are committed to trauma/emergency care and you are not
the subject of my ranting.  However if you consider the whole body of
surgeons I think the picture looks less rosy - whether you are in the UK,
South Africa, Australia or the US.  If you do not work in a Level 1/2 trauma
centre, if you are a resident planning on going straight in to private
practice, if you are a laparoscopic left adrenal surgeon, I don't believe
the same zeal for trauma or emegency surgery is present.  If I am totally
off base, then I happily stand corrected, and certainly I was exaggerating
to make the point.  But the fact stands that emergency medicine developed
(initially) to fill a vacuum left by surgery, and some specialties (witness
cardiothoracics) are retreating to the operating room.  We need to make sure
trauma or acute care surgery doesn't go the same way.

Karim 

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of KMATTOX at aol.com
Sent: 03 October 2006 23:49
To: trauma-list at trauma.org
Subject: Re: Subacute Care Surgery (was trauma activation and
stratification)

In a message dated 10/3/2006 4:08:52 P.M. Central Standard Time,
karim at trauma.org writes:

1.  Because over the last 30 years surgeons have abdicated from the care of
the  emergency surgical patient.  &

This has not been the experience of the vast majority of the hospitals
around the world

k

2. Because it's cheaper to have one resuscitation area in a  hospital.

What are you talking about?   A resuscitation area is a  resuscitation area.

and the person who needs resuscitating after major trauma  really needs a 
surgeon, at least in the eyes and experience of virtually every  evaluation
which 
has occurred during the past 30 years.   

k
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Subacute Care Surgery (was trauma activation and stratification)